Editorials

Purified factor VIII

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7003.465 (Published 19 August 1995) Cite this as: BMJ 1995;311:465
  1. E G D Tuddenham,
  2. M Laffan
  1. Professor of haemostasis Haemostasis Research Group, MRC Clinical Sciences Centre, Royal Postgraduate Medical School, Hammersmith Hospital, London W12 0NN
  2. Director Haemophilia Centre, Hammersmith Hospital, London W12 0NN
  3. Professor Tuddenham will receive royalties from sales of Kogenate, a brand of recombinant factor VIII, if any ever gets sold in the United Kingdom.

    Theoretical advantages, but at a cost

    Patients with haemophilia A lack only factor VIII. Why give them anything else as replacement treatment? Previously the answer to this question was determined largely by the practical difficulty in separating factor VIII from fibrinogen, fibronectin, and immunoglobulins, so that concentrates contained <1% of factor VIII protein by weight. The question is now determined largely by finances: concentrates of extremely high purity are available but are more expensive. Are there sufficient advantages to merit their greater cost and are these offset by any disadvantages?

    The terminology of factor VIII concentrates is confusing. The term high purity has been applied to several concentrates prepared from plasma pools either by ion exchange and chromatographic techniques or by monoclonal antibody affinity columns. These achieve specific activities of 200 and >2000 U/mg respectively, but concentrates prepared using affinity columns require the addition of albumin as a stabiliser in the final product. In contrast the …

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